JPH07508444A - Intervertebral prosthesis that enables rotational stability and flexural/extension stability - Google Patents

Intervertebral prosthesis that enables rotational stability and flexural/extension stability

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Publication number
JPH07508444A
JPH07508444A JP6503013A JP50301394A JPH07508444A JP H07508444 A JPH07508444 A JP H07508444A JP 6503013 A JP6503013 A JP 6503013A JP 50301394 A JP50301394 A JP 50301394A JP H07508444 A JPH07508444 A JP H07508444A
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Prior art keywords
ligament
prosthesis
block
thin
ducts
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JP6503013A
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Japanese (ja)
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ヴォアデヴィル，ジル
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Individual
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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/08—Muscles; Tendons; Ligaments
    • A61F2/0811—Fixation devices for tendons or ligaments
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • A61B17/7062—Devices acting on, attached to, or simulating the effect of, vertebral processes, vertebral facets or ribs ; Tools for such devices
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/84—Fasteners therefor or fasteners being internal fixation devices
    • A61B17/842—Flexible wires, bands or straps
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/08—Muscles; Tendons; Ligaments
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/39—Markers, e.g. radio-opaque or breast lesions markers
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/44—Joints for the spine, e.g. vertebrae, spinal discs
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/08—Muscles; Tendons; Ligaments
    • A61F2/0811—Fixation devices for tendons or ligaments
    • A61F2002/0847—Mode of fixation of anchor to tendon or ligament
    • A61F2002/0852—Fixation of a loop or U-turn, e.g. eyelets, anchor having multiple holes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/08—Muscles; Tendons; Ligaments
    • A61F2/0811—Fixation devices for tendons or ligaments
    • A61F2002/0876—Position of anchor in respect to the bone
    • A61F2002/0888—Anchor in or on a blind hole or on the bone surface without formation of a tunnel
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30003—Material related properties of the prosthesis or of a coating on the prosthesis
    • A61F2002/3006—Properties of materials and coating materials
    • A61F2002/3008—Properties of materials and coating materials radio-opaque, e.g. radio-opaque markers
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30563—Special structural features of bone or joint prostheses not otherwise provided for having elastic means or damping means, different from springs, e.g. including an elastomeric core or shock absorbers
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2250/00—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2250/0014—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis
    • A61F2250/0039—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis differing in diameter
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2250/00—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2250/0058—Additional features; Implant or prostheses properties not otherwise provided for
    • A61F2250/0096—Markers and sensors for detecting a position or changes of a position of an implant, e.g. RF sensors, ultrasound markers
    • A61F2250/0098—Markers and sensors for detecting a position or changes of a position of an implant, e.g. RF sensors, ultrasound markers radio-opaque, e.g. radio-opaque markers

Abstract

PCT No. PCT/FR93/00664 Sec. 371 Date Feb. 8, 1995 Sec. 102(e) Date Feb. 8, 1995 PCT Filed Jun. 30, 1993 PCT Pub. No. WO94/01057 PCT Pub. Date Jan. 20, 1994A prosthesis including (a) a flexible ligament (1) with a first narrowed thinner portion (2) and a second wider portion (3) forming an extension of, and having a greater width and thickness (e2) than, the first portion, which portion may be passed around the spinous processes (12) of two adjacent vertebrae (L5, L4) in a figure eight pattern, whereas the second portion circles around the processes; (b) a semi-flexible interprocess block (6) with two pairs of through-channels (7, 8) having differing cross-sections and receiving the respective portions of the ligament; and (c) members (4, 5) for joining the ends of the ligament. The prosthesis prevents sagittal and frontal lumbar vertebral rotational instability.

Description

【発明の詳細な説明】 回転安定性及び撓み／伸び安定性を可能にする椎間人工補装具本発明は椎間人工 補装具に関する。[Detailed description of the invention] An intervertebral prosthesis that allows for rotational stability and flexural/extension stability. Regarding assistive devices.

従来、剛性の或いは可撓性の種々の椎間保持人工補装具がつくられてきた。これ らの人工補装具の機能は、腰椎の額面方向及び矢状面方向での回転の不安定性を なくすことである。剛性の人工補装具は、プレート、フックを備えたロッドから なり、可撓性の人工補装具は、剛性の又は可撓性の部材と関連した靭帯によって 形成される。A variety of rigid and flexible intervertebral retention prostheses have been created in the past. this The function of these prostheses is to reduce the rotational instability of the lumbar vertebrae in the paral and sagittal planes. It is to eliminate it. Rigid prostheses are made from plates, rods with hooks A flexible prosthesis is constructed by means of rigid or flexible members and associated ligaments. It is formed.

しかしながら、これらの周知の靭帯システムは、撓み／伸び及び回転を満足のい くように安定化させることができない。However, these known ligament systems do not allow satisfactory deflection/extension and rotation. It cannot be stabilized as much as possible.

従って、本発明の目的は、撓み／伸び及び回転を全く満足のいくように安定化さ せることができるように構成された靭帯型の椎間人工補装具を提供することであ る。It is therefore an object of the invention to provide a completely satisfactory stabilization of deflection/extension and rotation. To provide a ligament-type intervertebral prosthesis configured to allow Ru.

本発明によれば、椎間人工補装具は、 ａ）幅が小さく且つ薄い第１薄部分、及び該第１部分よりも幅が大きく且つ厚い 、第１部分と連続した第２広幅部分からなり、第１部分は、二つの隣接した椎骨 の葬突起の周りに８の字をなして紐通しできるようになっており、第２部分は骨 突起周囲の取り囲みを行うようになっている可撓性靭帯と、ｂ）靭帯の二つの部 分を夫々通すようになまた断面の異なる二対の連続したダクトが切っである半硬 質の蒜突起間ブロックと、Ｃ）靭帯をそれ自体の上に閉じるための手段とを有す る。According to the invention, the intervertebral prosthesis comprises: a) a first thin portion having a smaller width and being thinner; and a first thin portion having a larger width and being thicker than the first portion; , consisting of a second wide portion continuous with the first portion, the first portion being connected to two adjacent vertebrae. The string can be passed around the funeral protrusion in a figure 8 pattern, and the second part is attached to the bone. A flexible ligament that surrounds the protrusion, and b) two parts of the ligament. A semi-rigid piece with two pairs of continuous ducts with different cross-sections cut so as to pass through each part. C) a means for closing the ligament onto itself. Ru.

本発明の有利な実施例によれば、薄部分を通すための二つのダクトは、ブロック の中央部分に並置されており、靭帯の薄部分の二つのストランドを通すことので きる中央開口部を介して相互連通している。According to an advantageous embodiment of the invention, the two ducts for passing the thin section are are juxtaposed in the central part of the ligament and pass through the two strands of the thin part of the ligament. They communicate with each other through a central opening.

従って、本発明による人工補装具は、靭帯の広幅部分が骨突起周囲を取り囲むこ とによって推骨を撓み／伸びについて安定させると同時に靭帯の薄部材を韓突起 間を斜めに通すことによって推骨を回転について安定させることができる。Therefore, the prosthesis according to the invention allows the wide part of the ligament to surround the bony protrusion. This stabilizes the thrust bone against flexure/stretching, and at the same time stabilizes the thin member of the ligament against the Korean protrusion. By passing diagonally between the two, the thrust bone can be stabilized in terms of rotation.

靭帯は、適当な材料、例えば、種々の方向に編組されたポリエステル即ち「ダク ロン」の商標で周知の材料でつくられているのがよい。The ligament is made of a suitable material, for example polyester or "duct" braided in various directions. It is best to use materials well known under the trademark "Ron".

本発明の他の特徴及び利点は、本発明の一実施例を非限定的例として例示する添 付図面を参照してなされた以下の説明により更に明らかになるであろう。Other features and advantages of the invention are described in the appendix, which illustrates, by way of non-limiting example, one embodiment of the invention. It will become clearer from the following description with reference to the accompanying drawings.

第１図は、本発明による椎間人工補装具の靭帯の一実施例の斜視図である。FIG. 1 is a perspective view of one embodiment of a ligament of an intervertebral prosthesis according to the present invention.

第２図及び第３図は、第１図の靭帯の薄部分及び広幅部分の夫々の長さの、断面 の相違を示す部分斜視図である。Figures 2 and 3 are cross-sections of the respective lengths of the thin and wide parts of the ligament in Figure 1. It is a partial perspective view which shows the difference.

第４図は、本発明による人工補装具のブロックの一実施例の斜視図である。FIG. 4 is a perspective view of one embodiment of a block of a prosthesis according to the invention.

第５図は、第４図のブロックの平面図である。FIG. 5 is a plan view of the block of FIG. 4.

第６図は、第４図とは異なる角度で見たブロックの斜視図である。FIG. 6 is a perspective view of the block seen from a different angle than FIG.

第７図は、二つの隣接した腰椎の骨突起に取り付ける際の第１図乃至第６図の椎 間人工補装具の斜視図である。Figure 7 shows the vertebrae of Figures 1 through 6 when attached to the bony processes of two adjacent lumbar vertebrae. FIG. 2 is a perspective view of an interprosthetic prosthesis.

第８図は、完了時の人工補装具の取り付けを示す第７図と同様の斜視図である。FIG. 8 is a perspective view similar to FIG. 7 showing installation of the prosthesis upon completion.

第９図は、第８図の椎間人工補装具が設けられた腰椎の、背中側から見た正面図 である。Figure 9 is a front view from the back of the lumbar vertebrae with the intervertebral prosthesis of Figure 8 installed. It is.

本発明が関連した人工補装具は、二つの部分、即ち幅狭で薄い第１薄部分２、及 び第１部分２と連続しており且つこの部分２よりも広幅で厚さが大きい第２広幅 部分３からなる可撓性靭帯１を有する。非限定的な例示の数値例として、薄部分 １の幅１１　（第２図参照）は４ｍｍであるのがよく、その厚さｅｌは１市であ り、これに対し、広幅部分３の幅１２は８ｍｍであるのがよく、その厚さｅ２は ２市である。The prosthesis to which the invention relates consists of two parts: a first thin part 2 which is narrow and thin; and a second wide part that is continuous with the first part 2 and is wider and thicker than this part 2. It has a flexible ligament 1 consisting of parts 3. As a non-limiting illustrative numerical example, the thin section The width 11 (see Figure 2) of 1 is preferably 4 mm, and the thickness el is 1 city. In contrast, the width 12 of the wide portion 3 is preferably 8 mm, and the thickness e2 is There are 2 cities.

二つの部分２．３の端部は、靭帯１に通すことができるようになった糸４．５に よって延長されている。靭帯は、四箇所又は三箇所でそれ自体にＸ字形状に縫い 付けられる。The ends of the two parts 2.3 are attached to the thread 4.5, which can now be passed through the ligament 1. Therefore, it has been extended. The ligament is sewn into itself in an X shape in four or three places. Can be attached.

人工補装具は、半硬質の練突起間ブロック６（特に第４図、第５図、及び第６図 に示す）を更に有し、このブロックには、断面の異なる二対の連続したダクトが 切ってあり、ダクト７からなる第１対は、ブロックの中央部分に並置されており 、靭帯１の狭幅部分２の断面と対応する小さな断面を有し、二つのダクト８の各 々は、二つのダクト７の一方の側に配置され、ダクト７の断面よりも非常に大き な断面を有し、靭帯１の広幅部分３を受入れるようになっている。二つの中央ダ クト７は、二つのダクト７の分離隔壁に形成された中央開口部９を介して相互連 結されている（第９図参照）。ダクト７及び８は互いにほぼ平行であり、ブロッ ク６を真っ直ぐに貫通している。ブロック６は、椎骨を僅かに伸延された状態に 設定するように、種々の高さを持つことができる。The prosthesis consists of a semi-rigid interprotrusion block 6 (particularly Figs. 4, 5, and 6). ), and this block has two pairs of continuous ducts with different cross sections. The first pair of ducts 7 are juxtaposed in the central part of the block. , has a small cross section corresponding to the cross section of the narrow part 2 of the ligament 1, and each of the two ducts 8 are placed on one side of the two ducts 7, and are much larger than the cross section of the ducts 7. It has a wide cross-section and is adapted to receive the wide portion 3 of the ligament 1. two central da The ducts 7 are interconnected through a central opening 9 formed in the separating partition of the two ducts 7. (See Figure 9). Ducts 7 and 8 are approximately parallel to each other and block It passes straight through hole 6. Block 6 leaves the vertebrae in a slightly distracted state. Can have various heights as configured.

ブロックは、靭帯１と同じ材料でつくられており、例えば圧縮状態での剛性を高 めることのできる強化縫い目線１１によって半硬質にされている。The block is made of the same material as ligament 1, for example to increase stiffness in compression. It is made semi-rigid by reinforced seams 11 that can be tightened.

靭帯１及びブロック６からなる椎間人工補装具の装着は、以下の方法で行われる 。Attachment of the intervertebral prosthesis consisting of ligament 1 and block 6 is carried out in the following manner. .

第７図、第８図、及び第９図には、最後の四つの腰椎Ｌ５、Ｌ４、Ｌ３、Ｌ２、 及び仙骨Ｓが示してあり、人工補装具は、最初の二つの腰椎Ｌ５、Ｌ４に装着さ れるようになっている。外科医は、先ず最初に、ダクト７が骨突起の中央平面の いずれかの側を延びるようにブロック６を骨突起１２間に配置する。外科医は、 次いで、靭帯１の薄部分２で骨突起の周りに８の字をなして紐通しを行い、この 薄部分をダクト７の一方に連続的に通し、次いで中央オリフィス９に入れ、ここ から第２ダクトに入れる。その後、外科医は、椎骨Ｌ４の骨突起１２の第１の取 り囲みを行い、薄部分２の端部をダクト７の一方、オリフィス９、及び第２ダク ト７に再び導入し、最後に、椎骨Ｌ５の骨突起１２の周りでループをつくること によって紐通しを完了する。この段階で、薄部分２の二つのストランド間で糸４ によって縫合を行う。Figures 7, 8, and 9 show the last four lumbar vertebrae L5, L4, L3, L2, and sacrum S are shown, with the prosthesis attached to the first two lumbar vertebrae L5 and L4. It is now possible to The surgeon first makes sure that the duct 7 is in the midplane of the bony process. A block 6 is placed between the bony protrusions 12 so as to extend on either side. The surgeon is Next, pass the string through the thin part 2 of the ligament 1 in a figure 8 shape around the bone protrusion, and Pass the thin section continuously through one side of the duct 7 and then into the central orifice 9, where it into the second duct. The surgeon then removes the first bony process 12 of vertebra L4. The ends of the thin portion 2 are connected to one side of the duct 7, the orifice 9, and the second duct. 7 and finally making a loop around the bony prominence 12 of vertebra L5. Complete string threading. At this stage, thread 4 is inserted between the two strands of thin section 2. Perform suturing.

外科医は、次いて、二つの骨突起１２の周りで広幅部分３によって輔突起間取り 囲みを行い、広幅部分３を横ダクト８に通す。骨突起の周りでループをつくり終 わると、外科医は、広幅部分３の二つの端部を糸５で互いに縫合することによっ て装着を完了する。The surgeon then measures the ligament process by means of the wide section 3 around the two bony processes 12. Enclose it and pass the wide part 3 through the horizontal duct 8. Finish by making a loop around the bony prominence. Then, the surgeon sutures the two ends of the wide section 3 together with the thread 5. to complete the installation.

非限定的数値例として、靭帯１の狭幅部分２及び広幅部分３の断面に対して上文 中で与えられた表示を完全にする。広幅部分には短取り付は及び長取り付けの二 つの種類がある。短取り付けについては、例えば、靭帯１が４０ｃｍで、薄部分 ２についての２Ｑｃｍと広幅部分３についての２０ｃｍに分かれる。長取り付け については、靭帯１が６０ｃｍで、薄い狭幅部分２についての３Ｑｃｍと広幅部 分３についての３０ｃｍに分かれる。対応するブロック６の幅１３は１５ｍ１１ （第４図、第５図、及び第６図参照）であり、長さ１４は１５ｍｍであるが、高 さｈは８市乃至２２ルの間で変化する。As a non-limiting numerical example, for the cross section of the narrow part 2 and the wide part 3 of the ligament 1, Complete the representation given in. For wide parts, there are two types of short and long installations. There are two types. For short installations, for example, ligament 1 is 40 cm and the thin part It is divided into 2Qcm for 2 and 20cm for wide part 3. long mounting For example, ligament 1 is 60cm, thin narrow part 2 is 3Qcm and wide part is 3Qcm. Divided into 30cm about 3 minutes. The width 13 of the corresponding block 6 is 15m11 (See Figures 4, 5, and 6), and the length 14 is 15 mm, but the height is The height varies between 8 and 22 ru.

引っ張りに対する靭帯１の抵抗は、好適には、３００ｋｇ以上であり、その剛性 は５０ＯＮ／關以上である。The resistance of the ligament 1 to tension is preferably 300 kg or more, and its stiffness is more than 50 ON/square.

靭帯１及びブロック６は、有利には、放射線不透過性フィラメントで形成されて いる。The ligament 1 and the block 6 are advantageously made of radiopaque filaments. There is.

本発明による椎間人工補装具は、その形状のため及び占有容積が小さいため、推 骨Ｌ５、Ｌ４の両方を、回転及び撓み／伸びにおいて固定することができる。The intervertebral prosthesis according to the invention is recommended because of its shape and because it occupies a small volume. Both bones L5, L4 can be fixed in rotation and deflection/extension.

実際、従来使用された靭帯は、推骨の周りに８の字をなして紐通しを行い、次い でこの靭帯をこれらの椎骨の周りに再び通すことができない。In fact, conventionally used ligaments are made by threading a string around the thrust bone in a figure eight pattern, and then This ligament cannot be rethreaded around these vertebrae.

紐通しは、軸突起間ブロック６に通す度毎に取り付けを強固にする本発明による 靭帯１では、全ての方向で行われる。The string is passed through the shaft projection block 6 according to the present invention, which makes the attachment stronger every time the string is passed through the block 6 between the shaft protrusions. In ligament 1, it is performed in all directions.

ブロック６は、骨との直接的な摩擦が生じないようにするのに十分可撓性であり 且つ軸突起間の特定の距離を維持するのに十分剛性であるため、半硬質であると 考えることができる。The block 6 is sufficiently flexible to avoid direct friction with the bone. Semi-rigid because it is rigid enough to maintain a certain distance between the axial protrusions. I can think.

変形例として、特に、縫糸４．５を金属製ステーブル又はリベツトのような任意 の他の適当な手段に代えてもよい。As a variant, in particular the suture thread 4.5 can be attached to any suitable material such as a metal stable or rivet. Other suitable means may be used instead.

本発明が関連した人工補装具の靭帯１及びブロック６の装着についての記載は、 特に腰部の不安定性に関する。腰部の不安定性は、全ての種類のを椎異常、特に 腰部を柱管狭窄、峡部溶解、及び円盤の滑りに対する障害である。The description of the attachment of the ligament 1 and block 6 of the prosthesis to which the present invention relates is as follows: Especially regarding lumbar instability. Lumbar instability can include all kinds of vertebral abnormalities, especially The lumbar region is an obstacle to columnar canal stenosis, isthmus lysis, and disc slippage.

、、−＋＝、Ｉ−−−−−　ＰＣＴ／ＣＲ９３１００６６４,,-+=,I----- PCT/CR93100664

Claims (1)

【特許請求の範囲】 １．椎間人工補装具において、 ａ）幅（１１）が小さく且つ厚さ（ｅ１）が小さい第１薄部分（２）、及び該第 １部分よりも幅（１２）が大きく且つ厚さ（ｅ１）が大きい、第１部分と連続し た第２広幅部分（２）からなり、前記第１部分は、二つの隣接した椎骨（Ｌ５、 Ｌ４）の棘突起（１２）の周りに８の字をなして紐通しできるようになっており 、前記第１部分は棘突起周囲の取り囲みを行うようになっている可撓性靱帯（１ ）と、 ｂ）靱帯の二つの部分を夫々通すようになった断面の異なる二対の連続したダク ト（７、８）が切ってある半硬質の棘突起間ブロック（６）と、ｃ）靱帯をそれ 自体の上に閉じるための手段（４、５）とを有することを特徴とする、椎間人工 補装具。 ２．薄部分（２）を通すための二つのダクト（７）は、ブロック（６）の中央部 分に並置されており、靱帯の薄部分（２）の二つのストランドを通すことのでき る中央開口部（９）を介して相互連通し、広幅部分（３）を通すための二つのダ クト（８）は、薄部分を通すためのオリフィスの各側に配置されていることを特 徴とする、請求項１に記載の人工補装具。 ３．靱帯（１）を閉じるための手段は、二つの部分を延長する糸（４、５）から なり、固定は、Ｘ字形状縫合によって行われるか或いはリベット又は金属製ステ ープルのような同様の手段で行われることを特徴とする、請求項１又は２に記載 の人工補装具。 ４．ブロック（６）は、靱帯（１）と同じ材料でできており、例えば強化縫い目 （１１）によって半硬質にされていることを特徴とする、請求項１、２、又は３ に記載の人工補装具。[Claims] 1. In intervertebral prostheses, a) a first thin portion (2) having a small width (11) and a small thickness (e1); Continuous with the first part, the width (12) is larger and the thickness (e1) is larger than that of the first part. a second wide portion (2), said first portion comprising two adjacent vertebrae (L5, A string can be passed through the spinous process (12) of L4) in a figure 8 pattern. , the first portion includes a flexible ligament (1) adapted to surround the spinous process. )and, b) Two pairs of continuous ducts with different cross-sections, each passing through two parts of the ligament. c) A semi-rigid interspinous block (6) in which the ligaments (7, 8) have been cut, and c) the ligament. an intervertebral prosthesis, characterized in that it has means (4, 5) for closing on itself; Prosthetics. 2. Two ducts (7) for passing the thin part (2) are located in the center of the block (6). The two strands of the thin part (2) of the ligament are juxtaposed and can be passed through. The two ducts communicate with each other through a central opening (9) for passing the wide part (3). (8) are located on each side of the orifice for passing the thin section. 2. The prosthesis of claim 1, wherein the prosthesis is characterized by: 3. The means for closing the ligament (1) are from the threads (4, 5) extending the two parts. and fixation is done by X-shaped sutures or by rivets or metal studs. Claim 1 or 2, characterized in that the method is carried out by similar means, such as a prosthetic devices. 4. The block (6) is made of the same material as the ligament (1), for example with reinforced seams. Claim 1, 2, or 3, characterized in that it is made semi-rigid by (11). Prosthetic devices as described in.
JP6503013A 1992-07-07 1993-06-30 Intervertebral prosthesis that enables rotational stability and flexural/extension stability Ceased JPH07508444A (en)

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FR92/08391 1992-07-07
FR9208391A FR2693364B1 (en) 1992-07-07 1992-07-07 INTERVERTEBRAL PROSTHESIS FOR STABILIZING ROTATORY AND FLEXIBLE-EXTENSION CONSTRAINTS.
PCT/FR1993/000664 WO1994001057A1 (en) 1992-07-07 1993-06-30 Intervertebral prosthesis providing rotational and flexional/extensional stabilization

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ES2103085T3 (en) 1997-08-16
FR2693364A1 (en) 1994-01-14

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